Transvaginal needle bladder neck suspension for stress urinary incontinence: practicable methods but not optimal results.

BACKGROUND

To describe the principal methods of needle bladder neck suspension including complications and to evaluate their cure rates.

METHODS

The methods are described according to the original papers of Pereyra, Stamey and Raz. Figures of complications and cure rates are based on recent reviews and prospective studies.

RESULTS

The complication rates do not exceed those of other surgical procedures for stress incontinence. The frequencies of pain and suture removal, voiding disorder, and de novo detrusor instability are each in the range of 5-6%. Objectively assessed cure rates of the endoscopic needle bladder neck suspension are 87% after one year and for the non-endoscopic methods 70%. However, prospective studies have shown that this cure rates may deteriorate to approximately 40% after five years compared to 82% after the Burch colposupension.

CONCLUSION

The needle procedures should be reserved to patients who can only tolerate a minor surgical procedure and accept the risk of failure after a few years.